Skuteczność kliniczna oraz profil bezpieczeństwa leków antycholinergicznych w zespole pęcherza nadreaktywnego – przegląd systematyczny

*Tomasz Tatara, Dominik Olejniczak

Summary
Introduction. Overactive bladder (OAB) is a condition in which there are urinary frequency, urgency, urinary incontinence, difficulty in emptying the bladder. The term overactive is used in the neurogenic and not neurogenic voiding disorders. In OAB pharmacological treatment anticholinergic drugs (ACH) are used.
Aim. Evaluation of clinical efficacy and safety profile of anticholinergic drugs in patients with OAB.
Material and methods. Evaluation of clinical efficacy based on the results of primary studies and secondary evidence found in the context of a systematic review. The following literature databases were searched systematically: Medline, Embase, Cochrane Library and others.
Results. Finally 4 publications, corresponding to the three clinical trials and one meta-analysis met the inclusion criteria for the efficacy analysis. ACH were significantly more effective than PLC in reducing OAB symptoms: 63% vs 22%. There has been no significant differences in the frequency of micturition between ACH vs PLC, the mean change in incontinence episodes in 24 hours was also similar between groups. The initial and maximum bladder capacity after use of tolterodine significantly increased by an average of 36.8 ml and 82.3 ml (p = 0.0402 and p < 0.0001). Average number of catheterizations within 24 hours after ACH treatment was characterized by a declining trend from 4.7 in 12 week to 4.4 at 12 month of observation.
Conclusions. OAB pharmacological treatment improves patients quality of life and reduce exposure to serious complications of the urinary tract. ACH including solifenacin, tolterodine and oxybutynin have proven efficacy in the treatment of OAB with relatively favorable safety profile. OAB pharmacological treatment brings economic benefits associated with a decrease in professional activity limitations of patients.

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